Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1306985742 |
---|---|
Provider Name | Victor Roberto Torres |
First Address | Calexico, CA 92231-2521 |
Second Address | Brawley, CA 92227-2392 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2007 |
Last Update Date | 08/07/2007 |